Hand osteoarthritis and rheumatoid hand surgery

Treatment guided by pain and useful function

A visibly altered joint does not automatically need an operation. Conversely, a painful or unstable joint can be disabling even when the outward change looks modest. We discuss splints, hand therapy and other nonsurgical options alongside appropriate surgical treatment.

Osteoarthritis

The choice of operation depends on the joint and the balance between pain relief, movement and stability. Selected procedures may include joint fusion, joint replacement or other reconstruction. A fusion sacrifices motion at that joint to provide stability; an implant aims to preserve movement but brings risks such as loosening, instability and future revision. Thumb base arthritis requires its own assessment and treatment discussion.

Rheumatoid and inflammatory hand problems

Medical control of inflammatory disease remains important and is coordinated with your rheumatologist. Surgery can address selected persistent problems such as tendon inflammation or rupture, joint instability, deformity or nerve compression. The plan may involve tendon procedures, joint reconstruction or staged treatment. Perioperative medication decisions require coordination with the treating team; patients should not stop medication on their own.

Recovery and limitations

Recovery varies substantially between a limited soft-tissue procedure, a fusion and a joint replacement. Splinting and therapy are planned around the reconstruction. Risks include infection, wound problems, stiffness, persistent pain, tendon problems, failure of fusion or an implant, and further surgery. The aim is a worthwhile functional improvement within the limits of the disease and the available tissues.

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